Malaria Clinical Trial
Official title:
Identification of Pre-erythrocytic Target Antigens Induced by Plasmodium Falciparum Sporozoite Immunization Under Chemoprophylaxis
Malaria, a disease caused by the parasite Plasmodium, is one of the world's major infectious diseases. With approximately 627.000 deaths a year, there is desperate need for an effective vaccine. Though a number of vaccine-candidates have been developed, they have yet to achieve the level of efficacy necessary to eliminate malaria. It has been shown previously that healthy human volunteers bitten by malaria-infected mosquitoes while taking chloroquine, medicine that prevents malaria, are fully protected against a subsequent malaria challenge. This is called CPS-immunization. The unprecedented effectiveness of CPS-immunization makes it a good model to identify what immune responses protect against malaria, to further guide vaccine development. In this study we will use CPS-immunization to induce protection against malaria in healthy subjects and then analyse their immune response to a malaria challenge infection.
Rationale:
Malaria, a disease caused by the parasite Plasmodium, is one of the world's major infectious
diseases. With approximately 627.000 deaths a year, it is both a chief cause of morbidity
and mortality as well as a significant contribution to ongoing poverty in endemic countries.
Ultimately, the key to malaria control and hopefully eradication, would be an effective
vaccine. Though a number of vaccine-candidates have entered the pipeline of pre-clinical and
clinical development, they have yet to achieve the level of efficacy necessary for effective
malaria prevention. It has been shown previously that healthy human volunteers can be fully
protected against malaria infection with a homologous parasite by immunization with
Plasmodium parasites while taking chloroquine chemoprophylaxis (ChemoProphylaxis and
Sporozoites, CPS-immunization). The unprecedented efficacy of CPS-immunization makes it a
unique model to identify pre-erythrocytic target antigens for the development of a subunit
vaccine. Identification of antigens that play a significant role in the development of
sterile protection against malaria will provide a basis for the development and evaluation
of more effective sub-unit candidate vaccines.
Primary objective:
• To delineate the antibody repertoire directed against the pre-erythrocytic stages of
Plasmodium falciparum induced by CPS-immunization.
Secondary objectives:
- To assess the functionality of CPS-immunization induced antibodies.
- To determine T-cell antigen specificities in CPS-immunized, protected volunteers.
Exploratory objectives:
- To assess the functionality of CPS-immunization induced T-cells.
- To explore the adaptive and innate immune responses during CPS-immunization and early
malaria infection.
Study design:
This is a single-centre, randomized open-label study. A total of 15 volunteers will be
divided into two groups, one scheduled to receive CPS immunization (Group 1, n=10) and one
to receive only chloroquine prior to malaria challenge (Group 2, n=5).
Study population:
The study population will be comprised of male and female healthy subjects. A total of 15
subjects will be enrolled to participate in the study and randomized.
Intervention:
In the immunization group a total of four CPS immunizations will be performed, with 15 bites
from Plasmodium infected mosquitoes per immunization, over a period of four months, during
which volunteers will take chloroquine prophylaxis. The control group will take only
chloroquine prophylaxis during this period. All volunteers will undergo Controlled Human
Malaria Infection (CHMI) by exposure to 5 bites from Plasmodium falciparum sporozoite
infected mosquitoes.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Basic Science
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